flowchart TD
A{Crossley et al} --> B(3 months)
A--> C(6 months)
A--> D(12 months)
Kambhampati & Vaishya, 2019
How does muscle strength and funcional performance change over time after ACLR
A group of systematic Reviews with meta analysis
Databases: MEDLINE, EMBASE, CINAHL, Scopus, Cochrane CENTRAL, SPORTDiscus
Inclusion criteria: primary ACL injury, aged 18-40 years, with a quantitative measure of muscle strength or hop performance
Methodological Quality Assessed on domains outlined by Cochrane Collaboration
Comparison:
A group of systematic Reviews with meta analysis
Additional Criteria:
\[\begin{equation} RoM = \frac{90Nm}{100Nm} \end{equation}\]
Example: ACL Side compared to the contralateral side
ROM = 0.9 95%CI[0.85-0.95]
= ACL side is 0.9x weaker than the contralateral side
= 10% deficit in ACL side strength
Allow multiple (correlated) pieces of information from the same study to be included in a meta-analysis
flowchart TD
A{Crossley et al} --> B(3 months)
A--> C(6 months)
A--> D(12 months)
metafor package.Random effects:
(timepoint | cohort)
Fixed effect: timepoint
Robust variance estimation methods using clubSandwich package 🥪
28 studies 🇦🇺 🇬🇧 🇺🇸 🇮🇷 🇯🇵 🇩🇪 🇹🇷 🇧🇷 🇳🇴 🇰🇷
1103 ACL injured (all except 12 reconstructed) + 1145 controls
Mean age ranging from 19 to 38 years
Most timepoints between 7-12 months post ACL surgery
Limited information on activity levels
No consistent or widespread weakness of the hip or calf muscles after ACL injury
Limitations
Low sample size especially for hip IR, flexion, soleus and dorsiflexors
Variability and heterogeneity
Very low certainty evidence
Between-person deficits were 1.53x greater than within person (95%CI 1.15 to 2.19)